Pain Comm & Resp. Dysfunction Flashcards

1
Q

What are some Defenses of the Respiratory Tract?

A
  • Lymphoid tissues: adenoids, protective circle at entry point
  • Mucous blanket: airborne debris
  • Ciliary action: move up and out
  • Epiglottis: protective reflex
  • Cough: expulsive force
  • Position changes: drainage
  • Lymphatics: drain bronchi/oles
  • Humoral defenses: phagocytosis
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2
Q

What is chest physiotherapy used for?

A
  • To enhance clearance of mucus from the airway
  • Includes percussion, vibration, squeezing of the chest, cough, forceful exhalation, and breathing exercises
  • ThAIRapy Vest
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3
Q

How do you determine the size of an endotracheal tube?

A
  • Determine ETT size by one of these ways:
    • [Age in years + 16] divided by 4
    • “Pinky” finger is approximate size for ETT
    • Broselow resuscitation tape
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4
Q

What are some Complications of ETT Intubation?

A

×Hypoxia with accompanying bradycardia
×Aspiration
×Trauma
×Creation of air leaks
×Vagal-mediated changes in vital signs (bradycardia, etc)
×Sore throat
×Traumatic laryngitis
×Infection, glottic edema, and mucosal lesions of larynx
×Subglottic stenosis

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5
Q

What is respiratory failure?

A

It is the result of an acute obstruction of a major airway or cardiac arrest is sudden are readily apparent.

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6
Q

What is respiratory arrest?

A

the sudden inability to breathe

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7
Q

What is apnea?

A

Apnea is defined as the absence of breeding greater than 20 seconds or it can be a shorter. If accompanied with hypoxemia and bradycardia.

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8
Q

What are some predisposing conditions to respiratory failure?

A

×Obstructive lung disease: Increase resistance to airflow
×Restrictive lung disease: impaired lung expansion, loss of lung volume
×Primary inefficient gas transfer: inefficient gas transfer, insufficient alveolar ventilation

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9
Q

What are the clinical manifestations of respiratory failure?

A

Cardinal signs:
×restlessness, tachypnea, tachycardia, diaphoresis
Less obvious signs:
×Mood changes, headache, altered depth and pattern, hypertension, dyspnea, anorexia, increased cardiac output and urinary output, nasal flaring, _retractions, _ expiratory grunting, wheezing or prolonged expiration
Severe hypoxia:
× hypotension, depressed respirations, dimness of vision, bradycardia, arrhythmias, somnolence, cyanosis, stupor, coma, dyspnea

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10
Q

What are the commponents of the upper respiratory tract?

A

×Oronasopharynx, pharynx, larynx, and trachea

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11
Q

What are the components of the lower respiratory tract?

A

×Bronchi, bronchioles, and alveoli

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12
Q

What are some changes in the immune system as children grow older?

A

×Infants younger than 3 months—maternal antibodies
×3 to 6 months—infection rate increases
×Toddler and preschool ages—high rate of viral infections
×Older than 5 years—increase in Mycoplasma pneumonia and β-strep infections
×Increased immunity with age

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13
Q

How does a child’s anatomy factor into more respiratory illnesses?

A

×Diameter of airways plays significant role in respiratory illnesses
×Distance between structures is shorter, allowing organisms to rapidly move down
×Short eustachian tubes, more horizontal. Fluid becomes static and says there

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14
Q

What causes Nasopharyngitis (common cold) and what are the clinical manifestations?

A

Caused by numerous viruses:
×RSV, rhinovirus, adenovirus, influenza, and parainfluenza viruses
Clinical manifestations:
×Fever—varies with age of child
×Irritability, restlessness
×Decreased appetite and fluid intake
×Nasal inflammation
×Vomiting and diarrhea

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15
Q

What causes pharyngitis, what are the clinical manifestations, and how would you treat it?

A
  • Caused by GABHS group a beta-hemolytic streptococcal
    • Sequelae: rheumatic fever inflammation heart, joints, CNS and Scarlet fever: erythematous sandpaper-like rash
  • Clinical manifestations:
    • HA, fever, Abd pain, pharangitis
  • Treatment: Penicillin
  • Nursing care management: antibiotic education, warm saline gargles, fluid hydration
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16
Q

What are some Pharmacologic Interventions for Strep?

A

Penicillin

  • Oral
    • Needs 10-day treatment to decrease risk of rheumatic fever and glomerulonephritis post strep
    • Issues with medication compliance
  • IM: Penicillin G
    • Resolves compliance issue (one injection)
    • Painful injection
    • Penicillin G procaine is less painful injection
    • CANNOT give penicillin G by IV route
    • Erythromycin if penicillin allergy
  • Other antibiotics
17
Q

What are some manifestations of bleeding after a Tonsillectomy?

A
  • Observation—frequent swallowing?
18
Q

What are the clinical manifestations of Infectious Mononucleosis?

A

manifestations include: tend to six weeks after exposure malaise, sore throat, fever, generalized lymphadenopathy and splenomegaly. Usually symptoms appear insidiously with fatigue, lack of energy and sore throat

19
Q

What are the clinical manifestations, how would you manage it, and how would you prevent Influenza (Flu)?

A
  • Clinical manifestations: range from subclinical to severe, sore throat and nasal mucosa are dry, dry cough, hoarseness, fever chills flushed face, photophobia; febrile seizure, encephalitis, encephalopathy, myocarditis, otitis media, sinusitis, pneumonia
  • **Therapeutic management: ** symptomatic treatment antipyretic’s, who had ration, amantadine hydrochloride is effective in reducing symptoms for type a ministry within the first 24 to 48 hours after onset of symptoms. Rimantadine for patients over one year of age effective against type A. Zanamivir: treat patient seven years of age and older
  • Prevention: vaccination for children six months to 18 years
20
Q

What medication is used to treat otitis media?

A

Penicillin

21
Q

What are the clinical manifestations of Otitis Media with Effusion?

A

persistent middle ear fluid, hearing impairment

22
Q

Describe the nursing management for a child with Otitis Externa (swimmers ear)

A
23
Q

What are the clinical manifestations of croup and how would you manage it?

A
  • **Clinical manifestations: ** occurs in boys more than girls, ages six months to three years rare after six years of age.
    • Hoarseness, barking cough, strider, respiratory distress
  • Therapeutic management:
    • Airway protection, humidified oxygenation, fluids, nebulized epinephrine, Heliox
  • Nursing care management: reassure the patient and parents, decrease anxiety, symptom management
24
Q

What are Signs of Increasing Respiratory Distress in Children?

A
  • RESTLESSNESS
  • Tachycardia
  • Tachypnea
  • Retractions
    • Substernal
    • Suprasternal
    • Intracostal
25
Q

What are the clinical manifestations of bronchitis?

A

persistent dry, hacking cough that is worse at night becoming productive in 2 to 3 days

26
Q

What are the clinical manifestations of pneumonia?

A

×Fever, malaise, rapid respiration, and cough
×Chest or abdomen pain, nausea

27
Q

What are some characteristics of Chlamydial Pneumonia?

A

×Usually 2-19 weeks after delivery
×Infected mother transmits to fetus via ascending infection or during delivery
×Infant is afebrile with cough, tachypnea, rales

28
Q

What are some characteristics of Pertussis (Whooping Cough)?

A
  • Highest incidence in spring and summer
  • Highly contagious
29
Q

What are the clinical manifestations of Tuberculosis (TB)?

A

cough, fever, bloody sputum

30
Q

What puts a child at risk for Aspiration Pneumonia?

A

×Oily nose drops and petroleum distillates
×Solvents
×Talcum powder

31
Q

What are the Clinical Manifestations Hydrocarbon Pneumonia?

A
  • Coughing, vomiting, aspiration
  • CNS—agitation, restlessness, confusion, drowsiness, and coma
  • Elevated body temperature (37.8° to 40° C)
  • Dyspnea, cyanosis, tachycardia, tachypnea, nasal flaring, and retractions
  • Hemoptysis, pulmonary edema, severe cyanosis, and death within 24 hours of aspiration
32
Q

What is ARDS?

A

Characterized as respiratory distress and hypoxia within 72 hours after serious injury or surgery in person with previously normal lungs

33
Q

What are the clinical manifestations of a FB Aspiration?

A
  1. The child can’t speak
  2. Becomes cyanotic
  3. Collapses
34
Q

What are the clinical manifestation of ARDS?

A
  • Hyperventilations
  • tachypnea
  • Increasing respiratory effort
  • cyanosis
  • decreasing oxygenation saturation
35
Q

What are the characteristics of allergies?

A
  • Allergies occur repeatedly and are often seasonal
  • Allergies are seldom accompanied by fever
  • Allergies often involve itching in the eyes and nose
  • Allergies usually trigger constant and consistent bouts of sneezing
  • ×Allergies are often accompanied by ear and eye problems